内容紹介
A Case of Advanced Gastric Cancer with Tumor Embolus in Portal Vein Successfully Treated by Neoadjuvant Chemotherapy, Operation and Chemoradiotherapy
Summary
A 66-year-old man was admitted to our hospital with a diagnosis of advanced gastric cancer, with a tumor embolus in the portal vein and lymph node metastases. Since curative surgery was deemed impossible, we started neoadjuvant chemotherapy using S-1 plus CDDP. After 1 course of chemotherapy, the embolus in the portal vein disappeared. After additional chemotherapy, the primary tumor and lymph nodes were reduced in size, and a total gastrectomy with splenectomy and lymph node dissection was performed. Although he received S-1 medication as adjuvant chemotherapy, a tumor embolus in the portal vein appeared 8 months after the operation. Chemoradiotherapy(S-1+total of 50.4 Gy)was performed and the tumor embolus disappeared.
要旨
症例は66歳,男性。貧血の精査にて著明なリンパ節転移と門脈腫瘍栓を有する4型胃癌(cT4a,cN3,cM1,cStageⅣ)と診断。治癒切除困難と判断し,S-1+CDDP療法を開始。1コース後のCTにて,門脈腫瘍栓の消失と腫大リンパ節の縮小を認めた。5コース終了後にD2郭清を伴う胃全摘術を施行した。病理検査所見は,por1,pT3(SS),med,INFa,pN2,pStageⅢAで,組織学的効果判定はGrade 2であった。術後補助化学療法(S-1)を施行したが,8か月後に門脈腫瘍栓再発を来したため化学放射線療法を施行した結果,門脈腫瘍栓の消失が得られた。
目次
Summary
A 66-year-old man was admitted to our hospital with a diagnosis of advanced gastric cancer, with a tumor embolus in the portal vein and lymph node metastases. Since curative surgery was deemed impossible, we started neoadjuvant chemotherapy using S-1 plus CDDP. After 1 course of chemotherapy, the embolus in the portal vein disappeared. After additional chemotherapy, the primary tumor and lymph nodes were reduced in size, and a total gastrectomy with splenectomy and lymph node dissection was performed. Although he received S-1 medication as adjuvant chemotherapy, a tumor embolus in the portal vein appeared 8 months after the operation. Chemoradiotherapy(S-1+total of 50.4 Gy)was performed and the tumor embolus disappeared.
要旨
症例は66歳,男性。貧血の精査にて著明なリンパ節転移と門脈腫瘍栓を有する4型胃癌(cT4a,cN3,cM1,cStageⅣ)と診断。治癒切除困難と判断し,S-1+CDDP療法を開始。1コース後のCTにて,門脈腫瘍栓の消失と腫大リンパ節の縮小を認めた。5コース終了後にD2郭清を伴う胃全摘術を施行した。病理検査所見は,por1,pT3(SS),med,INFa,pN2,pStageⅢAで,組織学的効果判定はGrade 2であった。術後補助化学療法(S-1)を施行したが,8か月後に門脈腫瘍栓再発を来したため化学放射線療法を施行した結果,門脈腫瘍栓の消失が得られた。